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СИПАП-терапия у пациентов с синдромом обструктивного апноэ сна и артериальной гипертонией: мнение экспертов
СИПАП-терапия у пациентов с синдромом обструктивного апноэ сна и артериальной гипертонией: мнение экспертов
Литвин А.Ю., Елфимова Е.М., Чазова И.Е. СИПАП-терапия у пациентов с синдромом обструктивного апноэ сна и артериальной гипертонией: мнение экспертов. Системные гипертензии. 2018; 15 (2): 77–78. DOI: 10.26442/2075-082X_2018.2.77-78
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Аннотация
Сочетание синдрома обструктивного апноэ сна (СОАС) и артериальной гипертонии (АГ) является распространенной проблемой, затрагивающей как медицинские, так и социальные аспекты жизни больного. СИПАП-терапия является основным методом лечения нарушений дыхания во сне. Настоящий документ сфокусирован на современных данных о взаимосвязи СОАС и АГ и работах, оценивающих влияние СИПАП-терапии на артериальное давление, риск сердечно-сосудистых осложнений и качество жизни пациентов.
Ключевые слова: синдром обструктивного апноэ сна, артериальная гипертония, артериальное давление, СИПАП-терапия.
Key words: obstructive sleep apnea syndrome, arterial hypertension, blood pressure, CPAP-therapy.
Ключевые слова: синдром обструктивного апноэ сна, артериальная гипертония, артериальное давление, СИПАП-терапия.
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Key words: obstructive sleep apnea syndrome, arterial hypertension, blood pressure, CPAP-therapy.
Полный текст
Список литературы
1. Peppard PE, Young T, Barnet JH et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177: 1006–14.
2. Linz D, Woehrle H, Bitter T et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 2015; 104: 705–18.
3. Coccagna G, Mantovani M, Brignani F et al. Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (Nancy) 1972; 8: 1159–72.
4. Javaheri S, Drager LF, Lorenzi-Filho G. Principles and Practices of Sleep Medicine, Sleep and cardiovascular disease: present and future. 6th edition. Eds M.H.Kryger, T. Roth, W.C.Dement. Philadelphia: Elsevier, 2017; p. 1222–28.
5. Calhoun DA. Obstructive sleep apnea and hypertension. Curr Hypertens Rep 2010; 12: 189–95.
6. Bratton DJ, Stradling JR, Barbé F et al. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials. Thorax 2014; 69: 1128–35.
7. Bakker JP, Edwards BA, Gautam SP et al. Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity. J Clin Sleep Med 2014; 10: 365–9.
8. Alajmi M, Mulgrew AT, Fox J et al. Impact of continuous positive airway pressure. therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung 2007; 185: 67–72.
9. Fava C, Dorigoni S, Dalle Vedove F et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea: a systematic review and meta-analysis. Chest 2014; 145: 762–71.
10. Montesi SB, Edwards BA, Malhotra A et al. The effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med 2012; 8: 587–96.
11. Bazzano LA, Khan Z, Reynolds K et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 2007; 50: 417–23.
12. Haentjens P, Van Meerhaeghe A, Moscariello A et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007; 167: 757–64.
13. Mo L, He QY. Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials. Zhonghua Yi Xue Za Zhi 2007; 87: 1177–80.
14. Liu L, Cao Q, Guo Z et al. Continuous positive airway pressure in patients with obstructive sleep apnea and resistant hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 2016; 18: 153–8.
15. Muxfeldt ES, Margallo V, Costa LM et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension: a randomized controlled trial. Hypertension 2015; 65: 736–42.
16. Iftikhar IH, Valentine CW, Bittencourt LR et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens 2014; 32: 2341–50.
17. de Oliveira AC, Martinez D, Massierer D et al. The antihypertensive effect of positive airway pressure on resistant hypertension of patients with obstructive sleep apnea: a randomized, double-blind, clinical trial. Am J Respir Crit Care Med 2014; 190: 345–7.
18. Martínez-García MA, Capote F, Campos-Rodríguez F et al. for the Spanish Sleep Network Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial. JAMA 2013; 310: 2407–15.
19. Pedrosa RP, Drager LF, de Paula LK et al. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest 2013; 144: 1487–94.
20. Lozano L, Tovar JL, Sampol G et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens 2010; 28: 2161–8.
21. Elfimova E, Sukmarova Z, Rogoza A, Chazova I. Advantage Of Ambulatory Blood Pressure Monitoring Versus Clinical Blood Pressure Measurements In Control Of Goal BP Levels Achievement In Patients With Arterial Hypertension 2–3 Degree And Severe Obstructive Sleep Apnea Syndrome. Am J Respir Crit Care Med 185; 2012: A218.
22. Kohler M, Stoewhas AC, Ayers L et al. Effects of continuous positive airway plressure therapy withdrawal in patients with obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 2011; 184: 1192–9.
23. Shahrokh Javaheri et al. Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017 Feb 21; 69 (7): 841–58.
24. Thunström E, Manhem K, Rosengren A et al. Blood pressure response to losartan and continuous positive airway pressure in hypertension and obstructive sleep apnea. Am J Respir Crit Care Med 2016; 193: 310–20.
25. Chirinos JA, Gurubhagavatula I, Teff K et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 2014; 370: 2265–75.
26. McEvoy RD et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 375: 919–31.
2. Linz D, Woehrle H, Bitter T et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 2015; 104: 705–18.
3. Coccagna G, Mantovani M, Brignani F et al. Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (Nancy) 1972; 8: 1159–72.
4. Javaheri S, Drager LF, Lorenzi-Filho G. Principles and Practices of Sleep Medicine, Sleep and cardiovascular disease: present and future. 6th edition. Eds M.H.Kryger, T. Roth, W.C.Dement. Philadelphia: Elsevier, 2017; p. 1222–28.
5. Calhoun DA. Obstructive sleep apnea and hypertension. Curr Hypertens Rep 2010; 12: 189–95.
6. Bratton DJ, Stradling JR, Barbé F et al. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials. Thorax 2014; 69: 1128–35.
7. Bakker JP, Edwards BA, Gautam SP et al. Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity. J Clin Sleep Med 2014; 10: 365–9.
8. Alajmi M, Mulgrew AT, Fox J et al. Impact of continuous positive airway pressure. therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung 2007; 185: 67–72.
9. Fava C, Dorigoni S, Dalle Vedove F et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea: a systematic review and meta-analysis. Chest 2014; 145: 762–71.
10. Montesi SB, Edwards BA, Malhotra A et al. The effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med 2012; 8: 587–96.
11. Bazzano LA, Khan Z, Reynolds K et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 2007; 50: 417–23.
12. Haentjens P, Van Meerhaeghe A, Moscariello A et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007; 167: 757–64.
13. Mo L, He QY. Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials. Zhonghua Yi Xue Za Zhi 2007; 87: 1177–80.
14. Liu L, Cao Q, Guo Z et al. Continuous positive airway pressure in patients with obstructive sleep apnea and resistant hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 2016; 18: 153–8.
15. Muxfeldt ES, Margallo V, Costa LM et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension: a randomized controlled trial. Hypertension 2015; 65: 736–42.
16. Iftikhar IH, Valentine CW, Bittencourt LR et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens 2014; 32: 2341–50.
17. de Oliveira AC, Martinez D, Massierer D et al. The antihypertensive effect of positive airway pressure on resistant hypertension of patients with obstructive sleep apnea: a randomized, double-blind, clinical trial. Am J Respir Crit Care Med 2014; 190: 345–7.
18. Martínez-García MA, Capote F, Campos-Rodríguez F et al. for the Spanish Sleep Network Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial. JAMA 2013; 310: 2407–15.
19. Pedrosa RP, Drager LF, de Paula LK et al. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest 2013; 144: 1487–94.
20. Lozano L, Tovar JL, Sampol G et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens 2010; 28: 2161–8.
21. Elfimova E, Sukmarova Z, Rogoza A, Chazova I. Advantage Of Ambulatory Blood Pressure Monitoring Versus Clinical Blood Pressure Measurements In Control Of Goal BP Levels Achievement In Patients With Arterial Hypertension 2–3 Degree And Severe Obstructive Sleep Apnea Syndrome. Am J Respir Crit Care Med 185; 2012: A218.
22. Kohler M, Stoewhas AC, Ayers L et al. Effects of continuous positive airway plressure therapy withdrawal in patients with obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 2011; 184: 1192–9.
23. Shahrokh Javaheri et al. Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017 Feb 21; 69 (7): 841–58.
24. Thunström E, Manhem K, Rosengren A et al. Blood pressure response to losartan and continuous positive airway pressure in hypertension and obstructive sleep apnea. Am J Respir Crit Care Med 2016; 193: 310–20.
25. Chirinos JA, Gurubhagavatula I, Teff K et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 2014; 370: 2265–75.
26. McEvoy RD et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 375: 919–31.
2. Linz D, Woehrle H, Bitter T et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 2015; 104: 705–18.
3. Coccagna G, Mantovani M, Brignani F et al. Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (Nancy) 1972; 8: 1159–72.
4. Javaheri S, Drager LF, Lorenzi-Filho G. Principles and Practices of Sleep Medicine, Sleep and cardiovascular disease: present and future. 6th edition. Eds M.H.Kryger, T. Roth, W.C.Dement. Philadelphia: Elsevier, 2017; p. 1222–28.
5. Calhoun DA. Obstructive sleep apnea and hypertension. Curr Hypertens Rep 2010; 12: 189–95.
6. Bratton DJ, Stradling JR, Barbé F et al. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials. Thorax 2014; 69: 1128–35.
7. Bakker JP, Edwards BA, Gautam SP et al. Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity. J Clin Sleep Med 2014; 10: 365–9.
8. Alajmi M, Mulgrew AT, Fox J et al. Impact of continuous positive airway pressure. therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung 2007; 185: 67–72.
9. Fava C, Dorigoni S, Dalle Vedove F et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea: a systematic review and meta-analysis. Chest 2014; 145: 762–71.
10. Montesi SB, Edwards BA, Malhotra A et al. The effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med 2012; 8: 587–96.
11. Bazzano LA, Khan Z, Reynolds K et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 2007; 50: 417–23.
12. Haentjens P, Van Meerhaeghe A, Moscariello A et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007; 167: 757–64.
13. Mo L, He QY. Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials. Zhonghua Yi Xue Za Zhi 2007; 87: 1177–80.
14. Liu L, Cao Q, Guo Z et al. Continuous positive airway pressure in patients with obstructive sleep apnea and resistant hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 2016; 18: 153–8.
15. Muxfeldt ES, Margallo V, Costa LM et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension: a randomized controlled trial. Hypertension 2015; 65: 736–42.
16. Iftikhar IH, Valentine CW, Bittencourt LR et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens 2014; 32: 2341–50.
17. de Oliveira AC, Martinez D, Massierer D et al. The antihypertensive effect of positive airway pressure on resistant hypertension of patients with obstructive sleep apnea: a randomized, double-blind, clinical trial. Am J Respir Crit Care Med 2014; 190: 345–7.
18. Martínez-García MA, Capote F, Campos-Rodríguez F et al. for the Spanish Sleep Network Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial. JAMA 2013; 310: 2407–15.
19. Pedrosa RP, Drager LF, de Paula LK et al. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest 2013; 144: 1487–94.
20. Lozano L, Tovar JL, Sampol G et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens 2010; 28: 2161–8.
21. Elfimova E, Sukmarova Z, Rogoza A, Chazova I. Advantage Of Ambulatory Blood Pressure Monitoring Versus Clinical Blood Pressure Measurements In Control Of Goal BP Levels Achievement In Patients With Arterial Hypertension 2–3 Degree And Severe Obstructive Sleep Apnea Syndrome. Am J Respir Crit Care Med 185; 2012: A218.
22. Kohler M, Stoewhas AC, Ayers L et al. Effects of continuous positive airway plressure therapy withdrawal in patients with obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 2011; 184: 1192–9.
23. Shahrokh Javaheri et al. Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017 Feb 21; 69 (7): 841–58.
24. Thunström E, Manhem K, Rosengren A et al. Blood pressure response to losartan and continuous positive airway pressure in hypertension and obstructive sleep apnea. Am J Respir Crit Care Med 2016; 193: 310–20.
25. Chirinos JA, Gurubhagavatula I, Teff K et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 2014; 370: 2265–75.
26. McEvoy RD et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 375: 919–31.
________________________________________________
2. Linz D, Woehrle H, Bitter T et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 2015; 104: 705–18.
3. Coccagna G, Mantovani M, Brignani F et al. Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (Nancy) 1972; 8: 1159–72.
4. Javaheri S, Drager LF, Lorenzi-Filho G. Principles and Practices of Sleep Medicine, Sleep and cardiovascular disease: present and future. 6th edition. Eds M.H.Kryger, T. Roth, W.C.Dement. Philadelphia: Elsevier, 2017; p. 1222–28.
5. Calhoun DA. Obstructive sleep apnea and hypertension. Curr Hypertens Rep 2010; 12: 189–95.
6. Bratton DJ, Stradling JR, Barbé F et al. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials. Thorax 2014; 69: 1128–35.
7. Bakker JP, Edwards BA, Gautam SP et al. Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity. J Clin Sleep Med 2014; 10: 365–9.
8. Alajmi M, Mulgrew AT, Fox J et al. Impact of continuous positive airway pressure. therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung 2007; 185: 67–72.
9. Fava C, Dorigoni S, Dalle Vedove F et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea: a systematic review and meta-analysis. Chest 2014; 145: 762–71.
10. Montesi SB, Edwards BA, Malhotra A et al. The effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med 2012; 8: 587–96.
11. Bazzano LA, Khan Z, Reynolds K et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 2007; 50: 417–23.
12. Haentjens P, Van Meerhaeghe A, Moscariello A et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007; 167: 757–64.
13. Mo L, He QY. Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials. Zhonghua Yi Xue Za Zhi 2007; 87: 1177–80.
14. Liu L, Cao Q, Guo Z et al. Continuous positive airway pressure in patients with obstructive sleep apnea and resistant hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 2016; 18: 153–8.
15. Muxfeldt ES, Margallo V, Costa LM et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension: a randomized controlled trial. Hypertension 2015; 65: 736–42.
16. Iftikhar IH, Valentine CW, Bittencourt LR et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens 2014; 32: 2341–50.
17. de Oliveira AC, Martinez D, Massierer D et al. The antihypertensive effect of positive airway pressure on resistant hypertension of patients with obstructive sleep apnea: a randomized, double-blind, clinical trial. Am J Respir Crit Care Med 2014; 190: 345–7.
18. Martínez-García MA, Capote F, Campos-Rodríguez F et al. for the Spanish Sleep Network Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial. JAMA 2013; 310: 2407–15.
19. Pedrosa RP, Drager LF, de Paula LK et al. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest 2013; 144: 1487–94.
20. Lozano L, Tovar JL, Sampol G et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens 2010; 28: 2161–8.
21. Elfimova E, Sukmarova Z, Rogoza A, Chazova I. Advantage Of Ambulatory Blood Pressure Monitoring Versus Clinical Blood Pressure Measurements In Control Of Goal BP Levels Achievement In Patients With Arterial Hypertension 2–3 Degree And Severe Obstructive Sleep Apnea Syndrome. Am J Respir Crit Care Med 185; 2012: A218.
22. Kohler M, Stoewhas AC, Ayers L et al. Effects of continuous positive airway plressure therapy withdrawal in patients with obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 2011; 184: 1192–9.
23. Shahrokh Javaheri et al. Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017 Feb 21; 69 (7): 841–58.
24. Thunström E, Manhem K, Rosengren A et al. Blood pressure response to losartan and continuous positive airway pressure in hypertension and obstructive sleep apnea. Am J Respir Crit Care Med 2016; 193: 310–20.
25. Chirinos JA, Gurubhagavatula I, Teff K et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 2014; 370: 2265–75.
26. McEvoy RD et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 375: 919–31.
Авторы
А.Ю.Литвин*, Е.М.Елфимова, И.Е.Чазова
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*alelitvin@yandex.ru
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*alelitvin@yandex.ru
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*alelitvin@yandex.ru
________________________________________________
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*alelitvin@yandex.ru
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